The occupational hazards of emergency physicians

American Journal of Emergency Medicine

Volumn 18, Issue 3, 2000, Pages 300-311

  Dorevitch, Samuel ^a   Forst, Linda ^a  

^a UNIVERSITY OF ILLINOIS AT CHICAGO   (United States)

Author keywords

Blood born pathogen; Burnout; Depression; Emergency physician; Hepatitis; Human immunodeficiency virus; Latex allergy; Nitrous oxide; Occupational illness; Occupational injury; Radiation; Shift work; Tuberculosis; Workplace violence

Indexed keywords

LATEX; NITROUS OXIDE;

ALLERGY; BURNOUT; EMERGENCY HEALTH SERVICE; HEPATITIS B; HEPATITIS C; HUMAN; HUMAN IMMUNODEFICIENCY VIRUS INFECTION; INFECTION PREVENTION; INFECTION RISK; MEDICAL PRACTICE; OCCUPATIONAL HAZARD; PRIORITY JOURNAL; RADIATION EXPOSURE; REVIEW; RISK FACTOR; SHIFT WORKER; SLEEP DISORDER;

EID: 0034031085     PISSN: 07356757     EISSN: None     Source Type: Journal    
DOI: 10.1016/S0735-6757(00)90125-6     Document Type: Review

References (179)

1. Tandberg D, Stewart KK, Doezema D: Under-reporting of contaminated needlestick injuries in emergency health care workers. Ann Emerg Med 1991;20:66-70
2. McQuillan GM, Coleman PJ, Kruszon-Moran D, et al: Prevalence of hepatitis B virus infection in the United States: The National Health and Nutrition Examination Surveys, 1976 through 1994. Am J Public Health 1999;89:14-18
3. Jui J, Modesitt S, Fleming D, et al: Multicenter HIV and hepatitis B seroprevalence study. J Emer Med 1990;8:243-251
4. Kelen GD, Green GB, Purcell RH, et al: Hepatitis B and hepatitis C in emergency department patients. N Eng J Med 1992;326: 1399-1404
5. Henein MN, Lloyd L: HIV, hepatitis B, and hepatitis C in the code one trauma population. Am Surg 1997;63:657-679
6. Kaplan AJ, Zone-Smith LK, Hannegan C, et al: The prevalence of hepatitis C in a regional level I trauma center. J Trauma 1992;33: 126-128
7. Sloan EP, Mcill BA, Zalenski R, et al: Human immunodeficiency virus and hepatitis B virus seroprevalence in an urban trauma population. J Trauma 1995;38:736-741
8. Gyawali P, Rice PS, Tilzey AJ: Exposure to blood borne viruses and the hepatitis B vaccination status among healthcare workers in inner London. Occup Environ Med 1998;55:570-572
9. Iserson KV, Criss EA: Hepatitis B prevalence in emergency physicians. Ann Emerg Med 1985;14:119-122
10. Werner BG, Grady GF: Accidental hepatitis-B-surface-antigen-positive inoculations. Use of e antigen to estimate infectivity. Ann Int Med 1982;97:367-369
11. Relation of e antigen to infectivity of hBsAg-positive inoculations among medical personnel. Lancet 1976;1:492-494
12. CDC: Recommendations for prevention and control of hepatitis C virus (HCV) infection and HCV-related chronic disease. MMWR, 1998;47 (RR-19);1-39
13. Alter MJ: Epidemiology of hepatitis C. Hepatology 1997;26: 62S-5S (suppl)
14. McQuillan GM, Alter MJ, Moyer LA, et al: A population-based serologic study of hepatitis C infection in the United States, in Rizzetto M, Purcell RH, Gerin, JL et al (eds): Viral Hepatitis and Liver Disease, Edizioni Minerva Medica, Turin, 1997 5 pp. 267-270
15. Lanphear BP, Linnemann CC, Cannon CG, et al: Hepatitis C virus infection in healthcare workers: Risk of exposure and infection. Infect Control Hosp Epidemiol 1994;15:745-750
16. Puro V, Petrosillo N, and Ippolito, G: Risk of hepatitis C seroconversion after occupational exposure in health care workers. Am J Infect Control 1995;23:273-277
17. Hamid SS, Farooqui B, Rizvi Q, et al: Risk of transmission and features of hepatitis C after needlestick injuries. Infect Control Hosp Epidemiol 1999;20:63-64
18. Mitsui T, Iwano K, Masuko K, et al: Hepatitis C infection in medical personnel after needlestick accident. Hepatology 1992;16: 1109-1114
19. Polish LB, Tong MJ, Co RL, et al: Risk factors for hepatitis C infection among health care personnel in a community hospital. Am J Infect Control 1993;21:196-200
20. Thornburn D, Dundas D, Cameron SO, et al: The prevalence of hepatitis C (HCV) infection in health care workers (HCW) in Glasgow. Gut 1999;44(4S):11A
21. Morton TA, Kelen GD: Hepatitis C. Ann Emerg Med 1998;31: 381-390
22. Simons JN, Lary TP, Dawson GJ, et al: Isolation of novel virus-like sequences associated with human hepatitis. Nature Med 1995;1:564-569
23. Linnen J, Wages J, Zhang-Keck Z-Y, et al: Molecular cloning and disease association of hepatitis G virus: a transfusion-transmissible agent. Science 1996;271:505-508
24. Leary TP, Muerhoff AS, Simons JN, et al: Consensus oligonucleotide primers for the detection of GB virus C in human cryptogenic hepatitis. J Virol Methods 1996;56:199-121
25. Wang H-L, Jin D-Y: Prevalence and genotype of hepatitis G virus in Chinese professional blood donors and hepatitis patients. J Infect Dis 1997;175:1229-1233
26. Dawson GJ, Schluader FF, Pilot-Matias TJ, et al: Prevalence studies of GB virus-C infection using reverse transcriptase-polymerase chain reaction. J Med Virol 1996;50:97-103
27. Yashina TL, Favorov MO, Khudyakov YE, et al: Detection of hepatitis G virus (HGV) RNA: Clinical characteristics of acute HGV infection. J Infect Dis 1997;175:1302-1307
28. Tucker TJ, Louw SJ, Robson SC, et al: High prevalence of GBV-C hepatitis G virus infection in a rural South African population. J Med Virol 1997;53:225-228
29. Lightfoot K, Skelton M, Dew MC, et al: Does GB virus-C infection cause hepatocellular carcinoma in black Africans? Hepatology 1997;26:740-742
30. Tribel B, Oesterreicher C, Pohanka E, et al: GBV-C/HGV in hemodialysis patients: Anti-E2 antibodies and GBV-C/HGV-RNA in serum and peripheral blood mononuclear cells. Kidney Int 1998;53: 212-216
31. Gartner BV, Kaul H, Neutzling AG, et al: High prevalence of hepatitis G virus (HGV) infection in dialysis staff. Nephrol Dial Transplant 1999;14:406-408
32. Shibuya A, Takeuchi A, Sakurai K, et al: Hepatitis G infection from needle-stick injuries in hospital employees. J Hospital Infect 1998;40:287-290
33. Mphahlele MJ, Lau GKK, Carman WF: HGV: the identification, biology and prevalence of an orphan virus. Liver 1998;18:143-155
34. Marcus R, Culver D, Bell DM, et al: Risk of human immunodeficiency virus infection among emergency department workers. Am J Medicine 1993;94:363-370
35. Kelen GD, Shahan JB, Quinn TC: Emergency department-based HIV screening and counseling: Experience with rapid and standard serologic testing. Ann Emerg Med 1999;33:147-155
36. Kelen GD, DiGiovanna T, Bisson L, et al: Human immunodeficiency virus infection in emergency department patients: Epidemiology, clinical presentations, and risk to healthcare workers: The Johns Hopkins experience. JAMA 1989;262:516-522
37. Lewandowski C, Ognjan A, Rivers E, et al: Health care workers exposure to HIV-1 and HTLV I-II in critically ill resuscitated emergency department patients. Ann Emerg Med 1992;21:1353-1359
38. Jui J, Stevens P, Hedberg K, et al: HIV seroprevalence in emergency department patients: Portland, Oregon, 1988-1991. Acad Emerg Med 1995;2:773-783
39. Rudolph T, Bowen DG, Boyd CR, et al: Seroprevalence of human immunodeficiency virus in admitted trauma patients at a southeastern metropolitan/rural trauma center. Am Surg 1993;59:684-687
40. Baraff LJ, Talan DA, Torres M: Prevalence of HIV antibody in a noninner-city university hospital emergency department. Ann Emerg Med 1991;20:782-786
41. Kelen GD, DiGiovanna TA, Lofy L, et al: Human T-lymphotrophic virus (HTLV I-II) infection among patients in an inner-city emergency department. Ann Int Med 1990;113:368-372
42. DeCarli G, Puro V, Binkin NJ, et al: Risk of human immunodeficiency virus infection for emergency department workers. J Emerg Med 1994;12:737-744
43. Ippolito G, Puro V, Heponstall J, et al: Occupational human immunodeficiency virus infection in health care workers: Worldwide cases through September 1997. Clin Infect Dis 1999;28:365-383
44. Stricof RL, Morse DL: HTLV-III/LAV seroconversion following a deep intramuscular needlestick injury. N Engl J Med 1986;314:1115
45. Marcus R, the CDC Cooperative Needlestick Surveillance Group: Surveillance of health care workers exposed to blood from patients infected with the human immunodeficiency virus. N Engl J Med 1988;319:1118-1123
46. HIV seroconversion after occupational exposure despite prophylactic zidovudine therapy. Lancet 1993;341:1077-1078
47. Gerberding JL: Management of occupational exposures to blood-borne viruses. New Eng J Med 1995;332:444-451
48. Ippolito G, Puro V, De Carli G: The risk of occupational human immunodeficiency virus infection in health care workers. Arch Int Med 1993;153:1451-1458
49. Cardo DM, Culver DH, Ciesielski CA, et al: A case control study of HIV seroconversion in health care workers after percutaneous exposure. N Eng J Med 1997;337:1485-1490
50. CDC: Public health service guidelines for the management of health-care worker exposures to HIV and recommendations for postexposure prophylaxis. MMWR 1998;47(RR-7);1-28
51. Pinto LA, Landay AL, Berzofsky JA, et al: Immune response to human immunodeficiency virus (HIV) in healthcare workers occupationally exposed to HIV-contaminated blood. Am J Med 1997;102(5B): 21-24
52. Clerici M, Levin JM, Kessler HA, et al: HIV-specific T-helper activity in seronegative health care workers exposed to contaminated blood. JAMA 1994;271:42-46
53. Wears RL, Vukich DJ, Winton CN, et al: An analysis of emergency physicians' cumulative career risk of HIV infection. Ann Emerg Med 1991;20:749-753
54. McKinney WP and Young MJ: The cumulative probability of occupationally-acquired HIV infection: The risks of repeated exposures during a surgical career. Infect Control Hosp Epidemiol 1990;11: 243-247
55. McKenna MT, McCray E, Jones JL, et al: The fall after the rise: Tuberculosis in the United States 1991 through 1994. Am J Public Health 1998;88:1059-1063
56. Kirsch TD, Chanmugam A, Keyl P, et al: Feasibility of an emergency department-based tuberculosis counseling and screening program. Acad Emerg Med 1999;6:224-231
57. Taneja R, Merritt S, Vanek S, et al: Tuberculin screening of trauma admissions at a university hospital. A preventive strategy. Arch Surg 1995;130:1223-1226
58. Behrman AJ, Shofer FS: Tuberculosis exposure and control in an urban emergency department. Ann Emerg Med 1998;31:370-375
59. Prezant DJ, Kelly KD, Mineo FP, et al: Tuberculin skin test conversion rates in New York City emergency medical service health care workers. Ann Emerg Med 1998;32:208-213
60. Sokolove PE, Mackey D, Wiles J, et al: Exposure of emergency department personnel to tuberculosis: PPD testing during an epidemic in the community. Ann Emerg Med 1994;24:418-421
61. Jereb JA, Klevens M, Privett TD, et al: Tuberculosis in health care workers at a hospital with an outbreak of multidrug-resistant Mycobacterium tuberculosis. Arch Int Med 1995;155:854-859
62. Wenger PN, Otten J, Breeden A, et al: Control of nosocomial transmission of multidrug-resistant Mycobacteriom tuberculosis among healthcare workers and HIV-infected patients. Lancet 1995; 345:235-240
63. American College of Emergency Physicians: Emergency physician sues for contracting tuberculosis. EM Today 1999; June 9
64. CDC: The role of BCG vaccine in the prevention and control of tuberculosis in the United States. MMWR 1996;45(RR-4):1-18
65. Sepkowitz KA: Occupationally acquired infections in health care workers. Part I. Ann Int Med 1996;125:826-834
66. Sepkowitz KA: Occupationally acquired infections in health care workers. Part II. Ann Int Med 1996;125:917-928
67. Bolyard EA, Tablan OC, Williams WW, et al: Guideline for infection control in health care personnel, 1988. Am J Infect Control 1988;26:289-354
68. Lane NE, Paul RI, Bratcher DF, et al: Pediatric emergency physicians and communicable diseases. Can we be trusted to take care of ourselves? Ped Emerg Care 1997;13:308-311
69. Esposito TH, Jurkovich GJ, Rice CL, et al: Reappraisal of emergency room throracotomy in a changing environment. J Trauma 1991;31:881-885
70. Hammond JS, Eckes JM, Gomez GA, et al: HIV, trauma, and infection control: Universal precautions are universally ignored. J Trauma 1990;20:555-558
71. Evanoff B, Kim L, Mutha S, et al: Compliance with universal precautions among emergency department personnel caring for trauma patients. Ann Emerg Med 1999;33:160-165
72. Baraff LJ, and Talan DA: Compliance with universal precautions in a university hospital emergency department. Ann Emerg Med 1989;18:654-657
73. Michalsen A, Delclos GL, Davidson AL, et al: Compliance with universal precautions. J Occup Environ Med 1997;39:130-137
74. Henry K, Campbell S, Collier P, et al: Compliance with universal precautions and needle handling and disposal practices among emergency department staff at two community hospitals. Am J Infect Control 1994;22:129-137
75. Henry K, Campbell S, and Maki M: A comparison of observed and self-reported compliance with universal precautions among emergency department personnel at a Minnesota public teaching hospital: Implications for assessing infection control programs. Ann Emerg Med 1992;21:940-946
76. DiGiacomo JC, Hoff WS, Rotondo MF, et al: Barrier precautions in trauma resuscitations: Real time analysis utilizing videotape review. Am J Emerg Med 1997;15:34-39
77. AJIC: APIC position paper: prevention of device-mediated bloodborne infections to health care workers. Am J Infect Control 1998;26:578-580
78. Forst LS and Fletcher B: HIV prophylaxis for health care workers. J Occup Environ Med 1997;39:1212-1219
79. Henderson DK: Postexposure chemoprophylaxis for occupational exposures to the human immunodeficiency virus. JAMA 1999; 281:931-936
80. Turjanmaa K: Incidence of immediate allergy to latex gloves in hospital personnel. Contact Dermatitis 1987;17:270-275
81. Turjanmaa K, Reunala T: Incidence of positive prick test results to rubber protein. Contact Dermatitis 1990;23:279
82. Turjanmaa K, Makinen-Kiljunen S, Reunala T, et al: Natural rubber latex allergy: The European experience, Immunol Allergy Clin North Am 1995;15:71-88
83. Gautrin D, Infante-Rivard C, Dao T-V, et al: Specific IgE-dependent sensitization, atopy, and bronchial hyperresponsiveness in apprentices starting exposure to protein-derived agents. Am J Respir Crit Care Med 1997;155:1841-1847
84. Porri F, Lemiere C, Birnbaum J, et al: Prevalence of latex sensitization in subjects attending health screening: Implications for a perioperative screening. Clin Exp Allergy 1997;27:413-417
85. Tarlo SM, Sussman GL, Holness: Latex sensitivity in dental students and staff: A cross-sectional study. J Allergy Clin Immunol 1997;99:396-401
86. Ylitalo L, Turjanmaa K, Palosuo T, et al: Natural rubber latex allergy in children who had not undergone surgery and children who had undergone multiple operations. J Allergy Clin Immunol 1997;100: 606-612
87. Merret TJ, Merret J, Bhambri S, et al: Prevalence of latex-specific IgE antibodies in the United Kingdom. J Allergy Clin Immunol 1995;95:154
88. Ownby DR, Ownby HE, McCullough J, et al: The prevalence of anti-latex IgE antibodies in 1000 volunteer blood donors. J Allergy Clin Immunol 1996;97:1188-1192
89. Sosovec D, Bourne G, Davis D: Clinical assessment and effective management of latex allergy. Surg Serv Manage 1998;4: 11-15
90. Sinha A, Harrison PV: Latex glove allergy among hospital employees: a study in the north-west of England. Occup Med 1998;48:405-410
91. Kibby T and Akl M: Prevalence of latex sensitization in a hospital employee population. Ann Allergy Asthma Immunol 1997;78: 41-44
92. Lai, C-C, Yan D-C, Yu J, et al: Latex allergy in hospital employees. J Formos Med Assoc 1997;96:266-271
93. Liss GM, Sussman GL, Deal K, et al: Latex allergy: epidemiologic study of 1351 hospital workers. Occup Environ Med 1997;54:335-342
94. Grzybowski M, Ownby DR, Peyser PA, et al: The prevalence of anti-latex IgE antibodies among registered nurses. J Allergy Clin Immunol 1996;98:535-544
95. Watts DN, Jacobs RR, Forrester B, et al: An evaluation of the prevalence of latex sensitivity among atopic and non-atopic intensive care workers. Am J Indust Med 1998;34:359-363
96. Arellano R, Bradley J, and Sussman G: Prevalence of latex sensitization among hospital physicians occupationally exposed to latex gloves. Anesthesiology 1992;77:905-908
97. Sussman GI, Liss GM, Deal K, et al: Incidence of latex sensitization among latex glove users. J Allergy Clin Immunol 1998;101:171-178
98. Kelly KJ and Walsh-Kelly CM: Latex allergy: a patient and health care system emergency. Ann Emerg Med 1998;32:723-729
99. Palczynski C, Walusiak J, Ruta U, et al: Occupational allergy to latex - life threatening reactions in health care workers. Report of three cases. Int J Occ Med Env Health 1997;10:297-301
100. Moneret-Vautrin D, Beaudonunin R, Widmer S, et al: Prospective study of risk factors in rubber latex hypersensitivity. J Allergy Clin Immunol 1993;92:66-677
101. Gold M, Swartz, Braude B, et al: Intraoperative anaphylaxis in association with latex sensitivity. J Allergy Clini Immunol 1991;87: 662-6
102. Kelly KJ, Pearson ML, Kurup VP, et al: Anaphylactic reactions in patients with spina bifida during general anesthesia: Epidemiologic features, risk factors, and latex hypersensitivity. J Allergy Clin Immunol 1994;94:53-61
103. Orfan NA, Reed R, Dykewicz MS, et al: Occupational asthma in a latex doll manufacturing plant. J Allergy Clin Immunol 1994;95: 826-830
104. Lagier F, Vervloet D, Lhermet I: Prevalence of latex allergy in operating room nurses. J Allergy Clin Immunol 1992;90:319-322
105. Kurup VP, Kelly T, Elms N, et al: Cross reactivity of food allergens in latex allergy. Allergy Proc 1994;12:211-216
106. Hadjiliadis D, Banks DE, Tarlo SM: The relationship between latex skin prick test responses and clinical allergic responses. J Allergy Clin Immunol 1996;97:1202-1206
107. Weiss EL, Singer CM, Benedict SH: Physician exposure to ionizing radiation during trauma resuscitation: A prospective clinical study. Ann Emerg Med 1990;19:134-138
108. Ciraulo DL, Marini CP, Lloyd GT, et al: Do surgical residents, emergency medicine physicians, and nurses experience significant radiation exposure during the resuscitation of trauma patients? J Trauma 1994;36:703-705
109. Grazer RE, Meislin HW, Westerman BR, et al: A nine-year evaluation of emergency department personnel exposure to ionizing radiation. Ann Emerg Med 1987;16:340-342
110. Ingegno M, Nahabedian M, Tominaga GT, et al: Radiation exposure from cervical spine radiographs. Am J Emerg Med 1994;12: 15-16
111. Weiss EL, Singer CM, Benedict SH, et al: Physician exposure to ionizing radiation during trauma resuscitation: a prospective clinical study. Ann Emerg Med 1990;19:134-138
112. Singer CM, Baraff LJ, Benedict SH, et al: Exposure of emergency medicine personnel to ionizing radiation during cervical spine radiography. Ann Emerg Med 1989;18:822-825
113. Evans RJ, Cusak S, Parke T: Exposure of the hands to ionizing radiation in the resuscitation room of an accident & emergency department. Arch Emerg Med 1992;9:220-224
114. Grazer RE, Meislin HW, Westerman BR, et al: Exposure to ionizing radiation in the emergency department from commonly performed portable radiographs. Ann Emerg Med 1987;16:417-420
115. Schnieden V: Violence at work. Archives Emerg Med 1993;10: 79-85
116. Cembrowicz SP, Sheperd JS: Violence in the accident and emergency department. Med Sci Law 1992;32:118-122
117. Jenkins MG, Rocke LG, McNicholl BP, et al: Violence and verbal abuse against staff in accident and emergency departments: A survey of consultants in the UK and the Republic of Ireland. J Accid Emergy Med 1998;15:262-265
118. Lehmann LS, McCormick RA, Kizer KW: A survey of assaultive behavior in Vetrans Health Administration facilities. Psych Serv 1999;50:384-389
119. Rankins RC, Hendey GW: Effect of a security system on violent incidents and hidden weapons in the emergency department. Ann Emerg Med 1999;33:676-679
120. Ordog GJ, Wasserberger J, Ordog C, et al: Weapon carriage among major trauma victims in the emergency department. Acad Emerg Med 1995;2:109-114
121. Lavoie FW, Carter GL, Danzl DF, et al: Emergency department violence in United States teaching hospitals. Ann Emerg Med 1988;12:1227-1233
122. Drummond DJ, Spar LF, Gordon GH: Hospital violence reduction among high-risk patients. JAMA 1989;261:2531-2534
123. Ordog GJ, Wasserberger J, Ordog C, et al: Violence and general security in the emergency department. Acad Emerg Med 1995;2:151-154
124. Ikhanipour K, Juels CR, Langdorf MI: Pediatric pain control and conscious sedation: A survey of emergency medicine residencies. Acad Emerg Med 1994;1:368-372
125. Donaldson D and Meechan JG: The hazards of chronic exposure to nitrous oxide: an update. Br Dent J 1995;178:95-100
126. Amess JA, Burman JF, Rees GM, et al: Megaloblastic haemopoiesis in patients receiving nitrous oxide. Lancet 1978;2:339-342
127. Peric M, Vranes Z, Marusic M: Immunological disturbances in anaesthetic personnel chronically exposed to high occupational concentrations of nitrous oxide and halothane. Anaesthesia 1991;46: 531-537
128. Yagiela JA: Health hazards and nitrous oxide: A time for reappraisal. Anesthesia Progress. 1991;38:1-11
129. Shortridge-McCauley LA: Reproductive hazards: An overview of exposures to health care workers. AAOHN J 1995;43:614-621
130. Kugel G, Letelier C, Zive MA, et al: Nitrous oxide and infertility. Anesthesia Progress 1990;37:176-180
131. Cohen EN, Gift HC, Brown BW, et al: Occupational disease in dentistry and chronic exposure to trace anesthetic gases. J Am Dental Assoc 1980;101:21-31
132. Rowland AS, Baird DD, Wienberg CR, et al: Reduced fertility among women employed as dental assistants exposed to high levels of nitrous oxide. N Engl J Med 1992;327:993-997
133. Rowland AS, Baird DD, Shore DL, et al: Nitrous oxide and spontaneous abortion in female dental assistants. Am J Epidemiol 1995;141:531-538
134. Ahlborg G, Axelsson G, Bodin L: Shift work, nitrous oxide exposure and subfertility in among Swedish midwives. Int J Epidemiol 1996;25:783-790
135. Dula DJ, Skiendzielewski JJ, and Royko M: Nitrous oxide levels in the emergency department. Ann Emerg Med 1981;10:575-578
136. Kanmura Y, Sakai J, Yoshinaka H, et al: Causes of nitrous oxide contamination in operating rooms. Anesthesiology 1999;90:693-696
137. Louis-Ferdinand RT: Myelotoxic, neurotoxic and reproductive adverse effects of nitrous oxide. Adverse Drug React Toxicol Rev 1994;13:193-206
138. Shaw ADS and Morgan MA: Nitrous oxide: Time to stop laughing. Anaesthesia 1998;53:213-215
139. Kawachi I, Colditz GA, Stampfer MJ, et al: Prospective study of shift work and risk of coronary heart disease in women. Circulation 1995;92:3178-3182
140. Knutsson A, Akerstedt T, Jonsson BF, et al: Increased risk of ischaemic heart disease in shift workers. Lancet 1986;2:89-92
141. Taylor PJ and Pocock SJ: Mortality of shift and day workers. 1956-68. Br J Ind Med 1972;29:201-207
142. Nurminen T: Shift work and reproductive health. Scand J Environ Health 1998;24:28-34 (suppl 3)
143. Bisanti L, Olsen J, Basso O, et al and the European Study Group on Infertility and Subfecundity: Shift work and subfecundity: A European multicenter study. J Occup Environ Med 1996;38:352-358
144. Uehata T, and Sasakawa N: The fatigue and maternity disturbances of night workwomen. J Hum Ergol (Tokyo) 1982;11:465-474
145. Spinelli A, Figa-Talamanga I, Osborn J: Time to pregnancy and occupation in a group of Italian women, Int J Epidemiol 1997;26:601-609
146. Olsen J: Cigarette smoking, tea and coffee drinking, and subfecundity. Am J Epidemiol 1991;133:734-739
147. Costa, G: The problem: Shiftwork. Chronobiology Int 1997;14: 89-98
148. Siebenaler MJ and McGovern PM: Shiftwork consequences and health. AAOHN J 1991;39:558-567
149. Jung F: Shiftwork: its effect on health performance and well-being. AAOHN J 1986;34:161-164
150. Rosa RR, Colligan MJ: Shift work: Health and performance effects, in Rom, WN, (ed) Environmental and Occupational Medicine, (ed3) Third Edition, Lippincott-Raven, Philadelphia, 1998
151. Gordon NP, Cleary PD, Parker CE, et al: The prevalence and health impact of shiftwork. Am J Pub Health 1986;76:1225-1228
152. Smith-Coggins, Rosekind MR, Buccino KR, et al: Rotating shiftowork schedules: can we enhance physician adaptation to night shifts? Acad Emerg Med 1997;4:951-961
153. Smith-Coggins R, Rosekind M, Hurd S, et al: Relationship between day versus night sleep to physician performance and mood. Ann Emerg Med 1994;24:928-934
154. Adams SL, Roxe DM, Weiss J, et al: Ambulatory blood pressure and Holter monitoring of emergency physicians before, during, and after a night shift. Acad Emerg Med 1998;5:871-877
155. del Arco-Galan C, Suarez-Fernandez C, Gabriel-Sanchez R: What happens to blood pressure when on-call? Am J Hypertension 1994;7:396-401
156. Whitehead DC, Thomas H, and Slapper DR: A rational approach to shiftwork in emergency medicine. Ann Emerg Med 1992;21:1250-1258
157. Wright SW, Lawrence LM, Wrenn KD, et al: Randomized clinical trial of melatonin after night-shift work: Efficacy and neuropsychologic effects. Ann Emerg Med 1998;32:334-340
158. Thomas H, Schwartz E, and Whitehead DC: Eight- versus 12-hour shifts: Implications for emergency physicians. Ann Emerg Med 1994;23:1096-1100
159. Wallace M, Owens W, Levens M: Adaptation to twelve hour shifts, in Costa G Cesana G, Kogi K, et al (eds): Shiftwork: health, sleep and performance. Frankfort am Main, Peter Lang, 1990
160. Tucker P, Barton B, and Folkard S: Comparison of eight and 12 hour shifts: Impacts on health, wellbeing, and alertness during the shift. Occup Environ Med 1996;53:767-772
161. Todd C, Reid N, Robinson G: The quality of nursing care on wards working eight and twelve hour shifts: A repeated measures study using the MONITOR index of quality of care, Int J Nurs Stud 1989;26:359-368
162. Maslach C, Jackson SE: The measurement of experienced burnout. J Occup Behav 1981;2:99-113
163. Employee burnout: America’s newest epidemic. Minneapolis MN, Northwestern Mutual Life, 1991
164. Goldberg R, Boss RW, Chan L, et al: Burnout and its correlates in emergency physicians: Four years' experience at a wellness both. Acad Emerg Med 1996;3:1156-1164
165. Lloyd S, Streiner D, and Shannon S: Burnout, depression, life and job satisfaction among Canadian emergency physicians. J Emerg Med 1994;12:559-565
166. Keller KL and Koenig WJ: Management of stress and burnout in emergency physicians. Ann Emerg Med 1989;18:42-47
167. Maslach C, Jackson SE: Burnout in health professionals: a social psychological analysis, in Sanders G, Suis J (eds): Social Psychology of Health and Illness. Hillsdale, NJ, Erlbaum, 1981
168. Doan-Wiffins L, Zun L, Cooper MA, et al: Practice satisfaction, occupational stress, and attrition of emergency physicians. Acad Emerg Med 1995;2:556-563
169. Reinhart MA, Munger BS, and Rund DA: American Board of Emergency Medicine longitudinal study of emergency physicians. Ann Emerg Med 1999;33:22-32
170. Murphy JG and Jacobson S: Satisfaction with practices: Emergency physicians versus internists. Ann Emerg Med 1987;16: 277-283
171. Anwar RA: A longitudinal study of residency-trained emergency physicians. Ann Emerg Med 1983;12:20-24
172. Gallery ME, Whitley TW, Klonis LK, et al: A study of occupational stress and depression among emergency physicians. Ann Emerg Med 1992;21:58-54
173. Kletke PR, Marder WD, Silberger AB: The demographics of physician supply: Trends and projections. Chicago, American Medical Association 1987
174. Hall KN, Wakeman MA, Levy RC, et al: Factors associated with career longevity in residency-trained emergency physicians. Ann Emerg Med 1992;21:291-297
175. Hall KN and Wakeman MA: Residency-trained emergency physicians: Their demographics, practice evolution, and attrition from emergency medicine. J Emerg Med 1999;17:7-15
176. Keller KL and Koenig WJ: Sources of stress and satisfaction in emergency practice. J Emerg Med 1989;7:293-299
177. Gibbs W, Eisenberg M, Damon SK: Dangers of defibrillation: Injuries to emergency personnel during patient resuscitation. Am J Emerg Med 1990;8:101-104
178. Cone DC and McNamara RM: Injuries to emergency medicine residents on EMS rotations. Prehospital Emerg Care 1998;2:123-126
179. Nozaki H, Shinozawa Y, Fujishima S, et al: Secondary exposure of medical staff to sarin vapor in the emergency room. Intensive Care Med 1995;21:1032-1035